AB1734-PARE THE JOURNEY TOWARD DISEASE MANAGEMENT: A NATIONAL SURVEY OF GOUT PATIENTS SEEN BY A RHEUMATOLOGIST
Authors: J. Cooper, M. Winokur, K. Serota
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The purpose of this survey is to assess the multifaceted impact of gout patients' physical and emotional wellbeing prior to their seeking treatment from a rheumatologist. <h3>Objectives</h3> The objective of the survey is to better understand patients' experience related to obtaining a gout diagnosis and care seeking for their symptoms. This information is helpful in that it can improve rheumatologists' understanding of their patients' experience and provide better patient-centered care. <h3>Methods</h3> An online survey of self-reported, physician-diagnosed individuals with gout was conducted between May and July 2022. The 30-question survey collected responses pertaining to frequency of gout flares, point of care location(s), point of care provider(s), comorbidities, and a 4-point Likert-scale (strongly agree, agree, disagree, strongly disagree) on experiences living with gout. Sociodemographic data was also collected. <h3>Results</h3> At total of 355 self-reported, physician diagnosed individuals participated in the survey; results presented are unweighted. Among respondents, 88% reported a gout flare has negatively impacted their ability to do their job, care for loved ones, participate in activities, remain socially active, and/or enjoy their life (Table 1). Just four in 10 participants saw a rheumatologist within a year of first suffering with symptoms of gout. It took 37% of patients 2-5 years, 13% 6-10 years, and 6% more than 10 years to see a rheumatologist for their gout. Moreover, 56% of respondents reported to have visited multiple health care providers without getting a clear answer about their gout, and 46% saw multiple health care providers without getting an effective treatment plan. Close to half of respondents reported having gone to the emergency department because of a gout flare, and of those, about three-quarters were prescribed an opioid for pain relief (Graph 1). Additionally, 58% reported anxiety, depression or hopelessness because of gout pain. However, after seeing a rheumatologist, 82% reported their gout is getting better, and they are learning how to manage it – even with other co-morbid conditions. A full 84% of respondents reported living with at least one co-morbid condition, the most common being high blood pressure (48%), cardiovascular conditions (30%), diabetes (28%), obesity (27%), kidney disease 20% and kidney stones (19%). The male to female distribution of gout patient respondents is 64% male, 36% female. Most respondents (58%) identified as white, 16% as Black and 15% as Hispanic with the remaining 11% representing other racial/ethnic groups. The mean age was 43, and 42% are employed full-time. Roughly six in 10 are married and 43% have children under the age of 18. <h3>Conclusion</h3> Survey results demonstrate a substantial burden of disease has been placed on those suffering with undiagnosed, misdiagnosed or undertreated gout. The survey results confirm that many of those suffering with gout spend years searching for a diagnosis. Results also elucidate patients' struggle to connect with a health care provider who is knowledgeable about gout and to receive an effective treatment plan for managing their gout. Without appropriate care, patients continue to live with the pain and receive opioids to urgently mask symptoms. As opioids do not actually treat gout, these patients are not receiving appropriate care. This is unfortunate as gout can be successfully managed by working with knowledgeable health care providers and adhering to a plan of care. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.